In my U.S. Pat. No. 4,766,907 dated Aug. 30, 1988, and U.S. Pat. No. 4,893,635 dated Jan. 16, 1990, apparatus and a method for performing a percutaneous biopsy are disclosed. The apparatus includes a manipulator which comprises a long thin cannula needle having one end connected to a syringe cylinder. A cell retrieving instrument is slidably mounted in the needle, and one end of the cell retrieving instrument is connected to the syringe plunger. By this construction and arrangement, cells are obtained from the patient's lung by inserting the needle, with the cell retrieving instrument wholly contained therein, inwardly through the patient's chest into the lung. The cell retrieving instrument is held fixed while the needle is slid outwardly relative thereto, to thereby expose the cell retrieving instrument within the patient's lung. The needle is then held fixed while the cell retrieving instrument is slid outwardly into the needle. The needle, the wholly contained instrument, and retrieved cell are then removed from the patient's lung.
The above-mentioned patents also disclose an activator device to which the manipulator is detachably connected to facilitate the direction, sequence, and distance of movement of the needle and associated cell retrieving instrument.
While the apparatus and method disclosed in my aforementioned patents were developed to meet a growing and unaddressed need for a simple, safe and effective non-surgical means to retrieve lung cells or tissue for diagnostic purposes and were directed to performing a percutaneous lung biopsy, there are times and circumstances when it is preferable to obtain a cytologic or histologic biopsy of the lung parenchyma using a transbroncheal method rather than a percutaneous method. The main advantage of the transbroncheal method over the percutaneous method, as they are both currently practiced, is the substantially lower incidence of pneumothorax; that is, allowing air to enter the pleural space, resulting in a collapsed lung.
Transbroncheal lung biopsy is presently performed almost exclusively with a flexible fiberoptic bronchoscope, wherein a small brush or biopsy forceps is passed through a "suction/forceps" channel provided in the bronchoscope, and then forced through a very small peripheral bronchus into the substance of the lung. This is all done using a fluoroscope to guide the distance the biopsy device is forced into the lung.
While conventional transbroncheal lung biopsys have been satisfactory, they have been characterized by certain disadvantages. For instance, a fluoroscope is required, thereby substantially increasing the expense of the procedure. Furthermore, the biopsy specimens are not always optimum. At times, especially when a small brush is employed, the biopsy instrument fails to enter the lung, whereby the specimen consists of cells or tissue harvested from the airway rather than from the lung. When biopsy forceps are employed, the instrument tends to crush the specimen, thereby distorting the histology to a variable degree.